Current treatment strategy for newly diagnosed chordoma of the mobile spine and sacrum: Results of an international survey Journal Article


Authors: Dea, N.; Fisher, C. G.; Reynolds, J. J.; Schwab, J. H.; Rhines, L. D.; Gokaslan, Z. L.; Bettegowda, C.; Sahgal, A.; Lazary, A.; Luzzati, A.; Boriani, S.; Gasbarrini, A.; Laufer, I.; Charest-Morin, R.; Wei, F.; Teixeira, W.; Germscheid, N. M.; Hornicek, F. J.; Delaney, T. F.; Shin, J. H.; for the AOSpine Knowledge Forum Tumor
Article Title: Current treatment strategy for newly diagnosed chordoma of the mobile spine and sacrum: Results of an international survey
Abstract: OBJECTIVE The purpose of this study was to investigate the spectrum of current treatment protocols for managing newly diagnosed chordoma of the mobile spine and sacrum. METHODS A survey on the treatment of spinal chordoma was distributed electronically to members of the AOSpine Knowledge Forum Tumor, including neurosurgeons, orthopedic surgeons, and radiation oncologists from North America, South America, Europe, Asia, and Australia. Survey participants were pre-identified clinicians from centers with expertise in the treatment of spinal tumors. The suvey responses were analyzed using descriptive statistics. RESULTS Thirty-nine of 43 (91%) participants completed the survey. Most (80%) indicated that they favor en bloc resection without preoperative neoadjuvant radiation therapy (RT) when en bloc resection is feasible with acceptable morbidity. The main area of disagreement was with the role of postoperative RT, where 41% preferred giving RT only if positive margins were achieved and 38% preferred giving RT irrespective of margin status. When en bloc resection would result in significant morbidity, 33% preferred planned intralesional resection followed by RT, and 33% preferred giving neoadjuvant RT prior to surgery. In total, 8 treatment protocols were identified: 3 in which en bloc resection is feasible with acceptable morbidity and 5 in which en bloc resection would result in significant morbidity. CONCLUSIONS The results confirm that there is treatment variability across centers worldwide for managing newly diagnosed chordoma of the mobile spine and sacrum. This information will be used to design an international prospective cohort study to determine the most appropriate treatment strategy for patients with spinal chordoma.
Keywords: oncology; radiation therapy; resection; management; outcomes; chordoma; sacrum; quality-of-life; phase-ii; carbon ion radiotherapy; mobile spine; radiation-therapy; local recurrence; chondrosarcomas; treatment strategy; dose photon/proton radiotherapy
Journal Title: Journal of Neurosurgery
Volume: 30
Issue: 1
ISSN: 0022-3085
Publisher: American Association of Neurological Surgeons  
Date Published: 2019-01-01
Start Page: 119
End Page: 125
Language: English
ACCESSION: WOS:000454623600015
DOI: 10.3171/2018.6.Spine18362
PROVIDER: wos
PUBMED: 30497218
Notes: Article -- Source: Wos
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  1. Ilya Laufer
    97 Laufer